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14721 ;w POST THIS RD NEAR FRONTOF BUILDING PERMIT NUMBER CIM OF . CUPERTINO 14721. :, INSPECTION DIVISION, JOB INSPECTION RECORD; • _ 77 gg ,�/ , / PERMIT EXPIRATION ' JOB ADDRESS /OIRJ NL `�d " _ UNIT# '_LOT# ' PERMIT EXPIRES IF WORK OWNER ; g+VAS CONTRACTOR IS NOT STARTED WITHIN INSPECTON DATE INSPECTOR INSPECTION RECORD dao DAYS OF PERMITISSU FOUNDATION - .ANCE OR 180 DAYS FROM NOTE: ' LAST CALLED INSPECTION. ' - UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE' TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB �y + PLUMBING' .. ELECTRICAL _ 'c ISSUANCE DATE MECHANICAL - ELEcr. PLG. MECH, UGE�,g El.. � . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - C Qe UILDING PERMIT WOOD FLOOR C��Of. INFORMATION PLUMBING VALUATION - $/F T, MECHANICAL - • ELECTRICAL - - PERMIT To FRAMING INSULATION ..- STORIES TYPE CONSTR. ' � � � , • - - DCC,GROUP RES UNITS PLACE NO•SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF• - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sD.FT.FLOOR Ar+eA TOTAL ACREAce .. DIAPHRAGM THE CONSTRUCTION TAX IS PAID --- BUI DING USE ROOF SHEATHINGRES IND CON PB Oink, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS . DATE INSP,• ' ''"❑ ` ❑- ❑. ' ❑ ❑ L "ROUGH SAN.# .ASSESSORS PARCEL NO PLUMBING , - ELECT.ENERGY - TRACT rvo. PARCEL No. TUBS&SHOWER PANT PLUMBING ENERGY T,• MECHANICAL' MECH.ENERGY ' ACC DATE ACC.FILE NO ELECTRICAL: BUILDING ENERGY - FRAMING ELECT,FINAL TEST - ' ZONING „ENG.SITE NO. INSULATION " PLUMBING GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T 2 • .O• _ Y ❑ N❑ Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING . " ELECTRICAL RELEASE FlDoq ZONE A.L.u.c " - EXTERIOR SHEAR . - - M- I' - INTERIOR SHEAR- - - FIRE DEPT. ' 7❑ N❑ Y ❑' N❑ SHEETROCK - - GRADE - - FEE SUMMARY EXTERIOR'.LATH BUILDING INTERIOR LATH - TEMPORARY APPROVALS 6UILDING SCRATCH COAT' - - ELECTRIC - PLAN CHECK GAS ' ' . .. - FEE V NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY' SEISMIC+,EE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM , ARRANGE FOR INSPECTION BY PHONING 252-4505, . ' ELECTRIC . F ONE WORKING DAY-BEFORE REQUIRED INSPECTION. PLUMBING , . z PLEASE'GIVEJOBADDRESSWHENPHONI,NG..` - SEE PERMIT FOR EXPIRATION DATE p, MECHANICAL a� G IMPORTANT! coNST.'TAx PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. `TOTAL OFFICE COPY fl;k�� Fnt=_rfls5 . ... / APPLICANT TO FILL ININFORMATIO (THIN RED LINES - USE BALL POINT PEN ONLY I.N PROJECT I DENTI --BUILD FIC PERMIT NUMBER .• BUILDING I APPLICATION & PE T �� .. X14721 ADDRESS '•'D �\ 12 • N�WG •R D BUILDING - ELECTRICAL-PLUMBING-.MECHANICAL �,,, OWNER'S _ PLAN CHECK VALIDATION "W CST I Ct J> APCvHON Z 3GAME -7 QTY. ELECTRIC PERMIT FEE �• CONTRACTORS - NAME UTLETS-SWITCHES-.RECEP 10.00/1.00 ^ �WODJ I�`•IC-<Nm.No. 53 Y 3 1 LIGHTING FIXTURES 10.00/1.00 c-oNTff&se50_ .„GOA1A wR APPLIANCES-RESIDENTIAL 4.00 IN GfI / FHON!/JO�_/J/ PANELS 10.00 - - OATS OF APPLICATION ARCHITECT PANELS (OVER 200 Ali 20.00 PLANCHECKFEE P.C.NO. OR ENGINEER - - uc.No. - SIGNS TRANS. 3.00 ADDRRESS ENG. - SPECIAL CIRCUIT 5,00 PERMIT VALIDATION P EMP.METER OR POLE INS. 20.00 T's � •�_- ., - APPucANM T - SEE FEE SCH. p AODRBss \SOWPO� � .� 7y SERVICE CHANGE 20.00 - /p woo LICENSED CONTRACTORS DECLA0.AT10N te¢ic u 1 hereby affirm that I am licensed under provisions of Chapter r) - ISSUnNCE DATE n<W (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. o'^ i s CSjd�e,and m Iy'e�se is in full for a d e k I. Z,o= C0 Lic.Numb L ❑ ❑ ❑ Q D ° Date Contractor i P x f - BUILDING PERMIT ¢ ¢ m ¢ OWNER-BUILUE0.OECLA0.A- 'T7SiT - INFORMATION wo d MISC.- •REFER TO ORD ;LL N I hereby affirm that I am exempt from the Contractor's License u_o¢ Law for the following reason.(Sec.7031.5,Business and Professions .PERMIT ISSUANCE 10.00 VALUATION $/FT. Code:Any city or county which monies a permit to construct,alter, _ QQ Q improve,demolish,or repair any structure,prior to Its issuance,alio ELEC.CONTE. LIC.NO. ELEC. o ¢ requires the applicant for such pennil to file a signed statement that TOTAL' PERMIT.TO e w m LL he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9(Commencing with Section 7000)of Division 3 of the M��' a Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE - Ce c the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR. i ;`a by any applicant for a pennil subjects the applicant toacivil penally ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500).1: ❑ 1,as owner of the properly,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 . their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered'to-,ale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner(it - - properly who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. mems are not intended or offered for sale.IL however,the building GAS-EA.SYSTEM-111NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or mi- prove for purpose of sale.). INDUSTRIAL WAS TE INTER. 30.00 RES , IND CON PB Omer ❑ 1,as owner of the property,am exclusively contracting with - -❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code-The Comractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. , r ❑ I asst exempt under Ser' ,B.&P.C.for this WATERHEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.'• WORKERS'COMPENSATION DECLARATION' WATER TREATING EQUIP, I hereby affirm that I have a certificate ofconsent to self-insuie. ZONING or a certifc.te of Workers'Compe�llion I�nsutam r a cei-ified ENG.SITE NO. co Cher oG f}$;yni804�n.C.)!1{•rr/'�-st,+l� - (JJE�(fd y-fished. -R/J Q '❑ Certilied copy is hereby furnished. FIRE$PRINK ENERGY T-24 Z Z Ccr d 'o is filed wi the 'ty inspection division. -- O Aflplicatst� •• .�•r. _ _ A MISC.- REFER TO ORD. - y,❑ N❑ Y ❑ N❑ CC LO CERTIFICATF-OFEXEMI'TION FROIMhlW'OfRJR(ERS' ' PERMIT ISSUANCE 10.00 .FL000ZONE, A.L.U.C. LU > COMPENSATION INSURANCE PLO.CONTE. LIC.No. PLG, 0 (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ No hundred dollars IS 100)or less.) w`O - L) O I certify that in the performance of the work for which this per. CITY. MECHANICAL PERMIIp wFEE FEE SUMMARY LL H mit is issued,I shall-not employ any.ptoom in any manner so as to U become subject to the Workers'Compensation Laws of California.. y Date- Applicant• - ALTER OR ADD TO MECH. 0 BUILDING }.N NOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 'V�b PLAN CHECK provisions of the Labor Code, you omit forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=dF.M.) CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT OVER I0,000C. . 6.00 SEISMIC FEE I-hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5,00 the performance of the work f htch this permit is issued(Sec. MICROFILM 3097,CN.C.). /� HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name/-��/Y r� HEATING UNIT(OVER 100,000 B.T.U.)9,50 ELECTRIC' Lender's Address I certify that l have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all nacity,and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 n� hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000BTUISEEFEESCH. MECHANICAL off, above-mentioned properly for inspection purposes. - (We) agree to save, indemnify unJ keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX a in any way accrue against said City in conic ence oft h PERMIT ISSUANCE 10.00 at sg of this per m'I. MECH.CONT. LIG NO. MECH. ' F - TOTAL TOTAL • gnature of Applicant/Contractor DAC OFFICE COPY -